Citation Nr: 21076749 Decision Date: 12/27/21 Archive Date: 12/27/21 DOCKET NO. 14-38 835 DATE: December 27, 2021 REMANDED Entitlement to service connection for a respiratory disability, to include chronic obstructive pulmonary disease (COPD) and chronic bronchitis, as a form of COPD, is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Air Force from March 1969 to March 1999. During his period of service, he earned the Air Force Achievement Medal, Air Force Commendation Medal, Meritorious Service Medal with Oak leaf Clusters, Bronze Star, Vietnam Service Medal, Air Force Training Ribbon, Air Force Overseas Short Tour Ribbon, Air Force Overseas Long Tour Ribbon with three devices, National Defense Service Medal with one device, Air Force Longevity Service Award with six devices, Noncommissioned Service Officer Professional Military Education Ribbon with one device, Small Arms Expert Marksmanship Ribbon (Rifle), Republic of Vietnam Campaign Medal, Republic of Vietnam Gallantry Cross with device, Air Force Outstanding Unit Award with eight devices, Joint Meritorious Unit Award, and Air Force Conduct Medal with seven devices. This case was most recently before the Board in June 2020, at which time the Board remanded the issue of entitlement to service connection for a respiratory disability for further development. Entitlement to service connection for a respiratory disability The Veteran appeared for a VA respiratory conditions examination in October 2020. The examiner opined that it was less likely than not that the Veteran's COPD was incurred in or caused by service. In providing the opinion, the examiner further opined that it was less likely than not that the Veteran's COPD was due solely to exposure to herbicide agents during military service, as there were many other aerosolized etiologies implicated in the development of COPD. The examiner noted that the main confounding factor for this Veteran was that he was also a long-term smoker and was worked as an aircraft mechanic, thus exposing him to many petroleum-based fumes for most of his military and civilian careers. Accordingly, the presence of these confounding factors made it difficult to pin down the cause of the Veteran's COPD; however, a significantly raised incidence of disease as compared to a similarly aged non-exposed population will definitely mean that exposure to Agent Orange played a role. Unfortunately, the Board finds that this opinion does not substantially comply with the Board's June 2020 remand directives. Stegall v. West, 11 Vet. App. 268 (1998). Although the VA examiner opined that it was less likely than not that the Veteran's COPD was due solely to exposure to herbicide agents during military service, she failed to consider the Veteran's in-service exposure to petroleum-based fumes as a result of his military occupational specialty (MOS) as Aircraft Systems Chief Enlisted Manager. The Board acknowledges that once VA undertakes the effort to provide an examination when developing a service connection claim, an adequate examination must be provided. See Barr v. Nicholson, 21 Vet. App. 303, 312 (2007). As such, an addendum opinion with a complete rationale that considers the Veteran's in-service exposure to petroleum-based fumes should be obtained. The matter is REMANDED for the following action: Obtain an addendum opinion from the October 2020 VA examiner. A new examination should be obtained if deemed necessary by the examiner or if the October 2020 examiner is unavailable. The examiner must review pertinent documents in the Veteran's claims file in conjunction with the examination. This must be noted in the examination report. (a.) The examiner should state whether it is at least as likely as not (a 50 percent probability or greater) that the Veteran's COPD had its onset in service or is otherwise etiologically related to active service, to include in-service exposure to petroleum-based fumes and herbicide agents. In providing this opinion, the examiner's attention is directed to the October 2020 respiratory conditions examination in which the examiner noted the Veteran's in-service exposure to petroleum-based fumes as an aircraft mechanic was a confounding factor to his development of COPD. (CONTINUED ON NEXT PAGE) Rationale for all requested opinions shall be provided. If the examiner cannot provide an opinion without resorting to mere speculation, he or she shall provide a complete explanation stating why this is so. In so doing, the examiner shall explain whether the inability to provide a more definitive opinion is the result of a need for additional information or that he or she has exhausted the limits of current medical knowledge in providing an answer to that particular question(s). A. S. CARACCIOLO Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Tracy O. Joseph, Counsel The Board's decision in this case is binding only with respect to the instant matter decided. This decision is not precedential and does not establish VA policies or interpretations of general applicability. 38 C.F.R. § 20.1303.